Zumaeta AM, Wright A, Syngelaki A, et al. - Researchers here investigated the additive value of serum placental growth factor (PlGF) and pregnancy‐associated plasma protein‐A (PAPP‐A), in first‐trimester screening for preterm pre‐eclampsia (PE) by maternal factors, mean arterial pressure (MAP) and uterine artery pulsatility index (UtA‐PI). In addition, they inscribe the risk cut‐off and screen‐positive rate to achieve a desired detection rate of PE if PAPP‐A rather than PlGF was to be used for first‐trimester screening. In total, 60,875 singleton pregnancies were included in the study population; of these, 1,736 (2.9%) developed PE. Superior performance of first‐trimester screening for PE was observed with using a combination of maternal factors, MAP, UtA‐PI and PlGF vs maternal factors, MAP, UtA‐PI and PAPP‐A. The racial composition of the study population influenced the risk cut‐off and screen‐positive rate to achieve a desired detection rate of PE in first‐trimester screening for PE. In addition, the risk cut‐off and screen‐positive rate were influenced by whether the biomarkers used for screening are mean arterial pressure (MAP), uterine artery pulsatility index (UtA‐PI) and placental growth factor (PlGF) or MAP, UtA‐PI and pregnancy‐associated plasma protein‐A (PAPP‐A). The preferred biochemical marker is PlGF rather than PAPP‐A in first‐trimester screening for PE. However, when using PAPP‐A rather than PlGF, the same detection rate can be attained but at a higher screen‐positive rate.